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Obstet Gynecol Sci > Volume 54(10); 2011 > Article
Korean Journal of Obstetrics & Gynecology 2011;54(10):618-622.
DOI: https://doi.org/10.5468/KJOG.2011.54.10.618    Published online October 1, 2011.
Clinical outcomes of 1,041 total laparoscopic hysterectomies: Six years of experience in a single center.
Jeong Min Moon, Jae Hong No, Yong Tark Jeon, Byung Chul Jee, Yong Beom Kim
1Department of Obstetrics and Gynecology, Bundang Jesaeng General Hospital, Seongnam, Korea.
2Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea. ybkimlh@snubh.org
Abstract
OBJECTIVE
To evaluate the association between outcomes of total laparoscopic hysterectomy (TLH) and patient demographic and clinical factors. METHODS: The present study was performed on a total of 1,041 women who underwent TLH, with or without bilateral/unilateral salpingo-oophorectomy, from May 2003 to December 2008, excluding patients who also underwent other procedures simultaneously, including ovarian cystectomy, colporrhaphy, incontinence surgery, pelvic/para-aortic lymph node dissection, and/or omentectomy. The medical records were reviewed and clinical outcomes were analyzed. RESULTS: Mean patient age was 46.6 +/- 13.4 years, mean operation time was 103.4 +/- 42.3 minutes, and mean duration of total hospital stay was 5.4 +/- 2.9 days. The mean decrease in hemoglobin concentration from before operation to 1 day after surgery was 1.4 +/- 0.9 g/dL, and one patient required an intraoperative transfusion. The main diagnosis was leiomyoma including concomitant adenomyosis (62.2%), followed by adenomyosis (16.0%) and 32 early stage gynecologic malignancies including 20 patients with microinvasive cervical cancer, 10 with endometrial cancer, 1 with borderline ovarian cancer, and 1 with uterine sarcoma. Laparotomy conversion was occurred in 45 patients (4.2%), because of severe pelvic/abdominal adhesion or huge uterine size. Large uterine size was associated with a significantly higher rate of conversion (7.9% vs. 2.6%, P < 0.01), and a significantly longer operation time (110.5 minutes vs. 93.1 minutes vs. 95.3 minutes, P < 0.01). Overall, 6 patients (0.6%) experienced major complications, including two bowel perforations, two ureteral injuries requiring surgical repair, one vaginal evisceration, and one incisional hernia. CONCLUSION: TLH is a safe and acceptable alternative to standard hysterectomy for various indications, including malignancy.
Key Words: Hysterectomy, Outcome assessment


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